Hysteria Can't Fight AIDS

July 24, 1991

Hysteria does not make for good medical policies. An unfortunate example of the hysteria surrounding the acquired immune deficiency syndrome, surfacing just as many in Congress prepare to face elections, is the Senate's recent passage of two bills concerning health workers with AIDS.

The first, backed by the leaders of both parties, would direct the states to require health professionals doing "invasive" procedures to submit to tests for human immunodeficiency virus infection. That bill, crafted with a close eye on the new guidelines published by the Atlanta-based Centers for Disease Control, also requires review by a panel of experts before an infected person can perform dental extractions, bone or abdominal surgery, obstetric and gynecological procedures, heart and blood-vessel catheterization or other procedures. Mandating action by state medical societies against practitioners who violate its guidelines, the bill puts teeth into what otherwise would be a tame rendition of a doctor's ethical responsibility to the patients. So it is not surprising that major professional societies and AIDS advocacy groups have either backed this bill or expressed no serious opposition to it.

The second, backed by North Carolina Sen. Jesse Helms, would vest the final authority for a doctor's decisions in the Justice Department. It would mandate prison terms of at least 10 years and fines up to $10,000 for health-care workers who knew they had AIDS but failed to inform patients on whom they performed invasive procedures. Passed 81-18, this is a bill many senators probably supported rather than face the fears and confusion many of their constituents express about AIDS.

With five confirmed AIDS cases stemming from the infection of Florida dentist David J. Acer before he died, members of the American public are anxious about the possibility of catching AIDS from a medical worker. And simply repeating that those five infections add up to a minuscule proportion of the 182,000 AIDS cases since the disease was identified in 1981 cannot reassure everyone. No one wants to be No. 6 out of 200,000.

But a hysterical hunt to find infected medical workers and slap "quarantine" restrictions on their activities is not the answer, even if it appeals to Mr. Helms. The better answer, expressed in the Senate leadership bill, puts a rigorous medical review in between the patient and any infected professional and mandates disciplinary action for those who fail to comply with its guidelines. The witch-hunt answer might warm Mr. Helms' heart, but it could drive people who suspect they are infected to illegal, dangerous attempts to hide the evidence. And it would add new misery to the lives of people whose term on earth is already

foreshortened by this terrible disease. This is one piece of Senate business the House should reject summarily.

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